front 1 A man is brought to the ED after ingesting a toxic alcohol. Which
common alcohol is also used therapeutically as an antidote? | back 1 B. Ethanol |
front 2 The principal cellular description of ethanol’s action is: | back 2 D. Multiple receptor-channel signaling effects |
front 3 Ethanol elimination is best described as: | back 3 A. Zero-order metabolism |
front 4 After equivalent exposure, how is ethanol duration best
predicted? | back 4 C. Dose administered |
front 5 A patient acutely intoxicated with ethanol is at greatest immediate
risk for: | back 5 B. Respiratory failure |
front 6 Years of heavy ethanol use most directly predispose to damage
involving: | back 6 D. Liver, pancreas, peripheral nerves |
front 7 Chronic ethanol exposure increases hepatotoxic risk from
acetaminophen primarily by: | back 7 C. Inducing CYP2E1 |
front 8 The consequence of ethanol-induced CYP2E1 activity is increased
formation of acetaminophen’s: | back 8 A. Toxic metabolite |
front 9 Methanol poisoning becomes dangerous largely because alcohol
dehydrogenase generates: | back 9 D. Formate |
front 10 A patient after ingesting windshield fluid develops blurred vision
and severe acidosis. Most likely toxin? | back 10 B. Methanol |
front 11 In methanol poisoning, death most classically results from: | back 11 A. Respiratory failure |
front 12 Ethylene glycol toxicity is most closely associated with formation
of: | back 12 C. Toxic aldehydes and oxalate |
front 13 A patient with antifreeze ingestion later develops which major organ
injury? | back 13 D. Kidney damage |
front 14 The acid-base finding most associated with ethylene glycol poisoning
is: | back 14 B. Severe acidosis |
front 15 A hospitalized patient in acute ethanol withdrawal is most
appropriately treated with: | back 15 C. Diazepam |
front 16 Benzodiazepines reduce ethanol withdrawal symptoms mainly by: | back 16 A. Facilitating GABAA activation |
front 17 Which drug class is specifically listed for both prevention and
treatment of acute ethanol withdrawal syndrome? | back 17 D. Benzodiazepines |
front 18 Which agent listed for withdrawal is vitamin B1? | back 18 B. Thiamin |
front 19 Thiamin is required for synthesis of which coenzyme? | back 19 C. Thiamine pyrophosphate |
front 20 In a patient suspected of alcoholism, thiamin is administered
primarily to prevent: | back 20 A. Wernicke-Korsakoff syndrome |
front 21 The table specifically recommends giving thiamin to alcohol-related
patients by which route? | back 21 D. Parenteral |
front 22 The toxicity profile listed for thiamin is: | back 22 B. None |
front 23 The interaction profile listed for thiamin is: | back 23 C. None |
front 24 Which chronic alcoholism medication is a nonselective competitive
opioid receptor antagonist? | back 24 A. Naltrexone |
front 25 Both naltrexone and acamprosate are used primarily to: | back 25 D. Reduce relapse risk |
front 26 Which formulation detail applies to naltrexone? | back 26 B. Oral or long-acting parenteral |
front 27 A patient with alcohol use disorder takes oxycodone for chronic pain.
Which relapse-prevention drug may block opioid analgesia? | back 27 A. Naltrexone |
front 28 In a physically opioid-dependent patient, which alcoholism drug may
precipitate withdrawal? | back 28 C. Naltrexone |
front 29 Which toxicity is specifically listed for naltrexone? | back 29 D. GI effects and liver toxicity |
front 30 Acamprosate is best described mechanistically as having: | back 30 B. NMDA antagonism and GABAA agonism |
front 31 Which chronic alcoholism drug has a poorly understood
mechanism? | back 31 A. Acamprosate |
front 32 Which adverse effect pair is listed for acamprosate? | back 32 C. GI effects and rash |
front 33 Which drug deters drinking by causing aldehyde accumulation if
ethanol is consumed? | back 33 D. Disulfiram |
front 34 Disulfiram acts primarily by inhibiting: | back 34 B. Aldehyde dehydrogenase |
front 35 Which chronic alcoholism drug is noted as rarely used? | back 35 C. Disulfiram |
front 36 Taken alone, disulfiram usually causes: | back 36 A. Little effect |
front 37 A patient on disulfiram drinks wine. Which reaction is
expected? | back 37 D. Flushing, nausea, hypotension |
front 38 Which symptom is part of the classic disulfiram-ethanol
reaction? | back 38 B. Headache |
front 39 In acute methanol poisoning, the direct pharmacologic target of
fomepizole is: | back 39 B. Aldehyde dehydrogenase |
front 40 Fomepizole benefits toxic alcohol ingestion by: | back 40 C. Preventing toxic metabolite formation |
front 41 Which poisoning is an indication for fomepizole? | back 41 D. Methanol ingestion |
front 42 Which additional poisoning is also treated with fomepizole? | back 42 B. Ethylene glycol ingestion |
front 43 Fomepizole is specifically described as an: | back 43 A. Orphan drug |
front 44 Which adverse effect is listed for fomepizole? | back 44 C. Dizziness |
front 45 Which additional adverse event is a rare fomepizole toxicity? | back 45 D. Allergic reaction |
front 46 Besides fomepizole, which agent can reduce toxic alcohol metabolism
by outcompeting substrates at alcohol dehydrogenase? | back 46 B. Ethanol |
front 47 Ethanol can serve as an antidote in methanol or ethylene glycol
poisoning because it has: | back 47 A. Higher alcohol dehydrogenase affinity |
front 48 Which ethanol clinical use is unrelated to toxic alcohol
ingestion? | back 48 C. Topical antisepsis |
front 49 chlordiazepoxide, diazepam, lorazepam are what? | back 49 benzos |
front 50 A patient drinks homemade alcohol and develops visual symptoms,
severe acidosis, then progressive unresponsiveness. Which additional
feature is classically associated with this poisoning? | back 50 A. Seizures |
front 51 Methanol toxicity is most characteristically associated with which
combination? | back 51 B. Coma and seizures |
front 52 A patient with decades of alcohol use develops multisystem injury.
Which additional system is specifically listed among chronic ethanol
toxicities? | back 52 B. Central nervous system |
front 53 In the ED, a confused patient with suspected alcoholism is still
intoxicated. Which adjunct should be administered now to reduce
neurologic risk? | back 53 C. Thiamin |
front 54 Thiamin administration is recommended in patients suspected of
alcoholism who present with: | back 54 A. Acute intoxication or withdrawal |
front 55 Which benzodiazepine example listed is commonly used in acute ethanol
withdrawal? | back 55 B. Diazepam |
front 56 Which additional listed benzodiazepine was specifically named for
acute ethanol withdrawal management? | back 56 C. Chlordiazepoxide |
front 57 Which adverse effect is specifically listed for fomepizole? | back 57 A. Headache |
front 58 A patient treated with fomepizole for ethylene glycol poisoning
develops mild medication-related symptoms. Which pair is most
consistent with the table? | back 58 B. Nausea and dizziness |
front 59 ophthalmoplegia, ataxia and disturbances of mentation and consciousness | back 59 Wernicke-Korsakoff syndrome |
front 60 shaking, confusion, high blood pressure, fever, hallucinations, death | back 60 delirium tremens |
front 61 (1) intrauterine growth retardation, (2) microcephaly, (3) poor coordination, (4) underdevelopment of midfacial region (appearing as a flattened face), and (5) minor joint anomalies | back 61 fetal alcohol syndrome |
front 62 Ethanol is a (vasoconstrictor/vasodilator), probably as a result of both CNS effects and direct smooth muscle relaxation caused by its metabolite, acetaldehyde. | back 62 vasodilator |
front 63 _______ appears to play a pivotal role in the progression of alcoholic liver disease and may be a fruitful therapeutic target. | back 63 TNF-a |
front 64 Heavy drinking—and especially “binge” drinking—are associated with both atrial and ventricular _______. | back 64 arrhythmias |
front 65 The most common hematologic disorder seen in chronic drinkers is mild _______ resulting from alcohol-related folic acid deficiency. | back 65 anemia |
front 66 Excess _______ production appears to contribute to the metabolic disorders that accompany chronic alcoholism and to both the lactic acidosis and _______ that frequently accompany acute alcohol poisoning. | back 66 NADH hypoglycemia |
front 67 Significant (increase/depression) of myocardial contractility has been observed in individuals who acutely consume moderate amounts of alcohol, ie, at a blood concentration above 100 mg/dL. | back 67 depression |
front 68 Since ethanol has low _______ , it requires concentrations thousands of times higher than other misused drugs | back 68 potency |
front 69 an estimated 15–30% of chronic heavy drinkers eventually develop severe _______ disease | back 69 liver |
front 70 _______ contributes to elevated portal blood pressure and esophageal and gastric venous varices. | back 70 Cirrhosis |